Just how bad are we at treating age-related diseases?

Anything that we are good at treating doesn’t seem like an age related disease anymore, but we’re really clearing out the scourges if you look at historical cause of death statistics. We haven’t made any progress on Alzheimer’s, and have conquered yellow fever, consumption, diabetes, knee failure, glaucoma, smoking related lung cancer, prostate cancer, hookworm, environmental lead poisoning, environmental arsenic poisoning, black lung, breast cancer, and syphilis. So, if you know someone old and suffering, its probably alzheimers.

Interesting, I wouldn't classify IPF (idiopathic pulmonary fibrosis) as a disease of aging in the same way as the other diseases (MASH, Alzheimer's, etc..) like the author did here. Although I do appreciate the intent to show how limited we are. It's kind of like how cancer is clearly a disease of aging but it wasn't included in here because people think of it differently.

I treat a lot of old people, and IPF is at least a couple orders of magnitude rarer than the other conditions listed. Age does play a role because it shows up when people are older, but there is something else at play in it (autoimmune, genetics) that makes people hit the unlucky lottery.

I bring this up so that people reading this don't conflate normal aging related changes to the lungs with IPF. IPF is a horrible disease that kills the person in a few years (2-5 after diagnosis).

My mother is in the early stages of Alzheimer's. It's terrible. I wouldn't recommend my experience on anyone. That might sound selfish, but it's just so painful to watch her deteriorate, knowing there's nothing that can be done. I watched her take a cognitive test recently - draw a clock, put the hands at 10 after 5. She worked on it for a minute or two, struggled, got it all wrong, then forgot what she was doing. It was one of the most painful things I've ever witnessed.

Sorry for the non-constructive comment. I guess the only constructive-ish thing is to recommend that if you've got elderly loved ones exhibiting short-term memory issues, get them tested ASAP. Then, get the "legal stuff" started right away (powers of attorney).

We'd be much closer to a cure if there wasn't that research fraud about the causes of Alzheimers that led science down a dead end for years[1].

[1]https://www.discovermagazine.com/the-sciences/false-alzheime...

We are bad at most things that are complex and require behavior change. Maybe our best victory in recent years has been the vilification of tobacco. It didn't get any less physically pleasurable to smoke, but the combination of political, social, economic, and medical pressure has turned the tide.

It takes a lot.

I like this article, but it, like a lot of things in medicine, seems to focus on the wrong question. It isn't about disease x, it is about quantity and quality of life. I thought the part about Geographic atrophy drugs really emphasized this well. The drugs do -something- but have no impact on quality of life. I really want drug trials to focus on these two things and not proxies like 'lesion growth' which doesn't appear to have a meaningful impact on quality of life. If quality and quantity of life are improving then we can say that we are improving medicine otherwise we are just increasing medicine or worse, medicine is hurting as quality of life drops due to medical procedures that provide no real benefit but have real cost.

Reading this article reminded me of my grandparents. In their time, people feared tuberculosis or stroke. Now, when I visit nursing homes, I hear more conversations about memory loss, knee pain, and insomnia. Even my mother now often has trouble sleeping, which has become a daily annoyance in her life. We have indeed made great progress. Many diseases that would have killed people in the past are now controllable and even less common. But at the same time, it seems that we have replaced a new batch of problems: Alzheimer's, loneliness, polypharmacy, insomnia. We live longer, but are we really living better?

Whatever happened to those blood transplants people were getting from younger people? Logically it made sense, but I'm guessing after further study it didn't pan out? Or was it just a trend that didn't get any follow up?

I have this age-related eye disease where all the text on a web page appears to be in a tiny, spindly font, and it appears to fade in as it scrolls. I would blame my eyeglasses, but I'm not wearing any. :-)

Unfortunately there's no current or proposed medical treatment for the inevitability of death and degradation on that path, so the only real treatment is philosophical.

At least in Western society, if any of you have experienced this struggle with an older relative burning through resources to desperately cling to life you know that we seem to lack some fundamental ability to approach or handle this topic philosophically.

In no time I'll in the same boat. Secular society doesn't really have a great answer here.

It’s only bad if enough people agree it’s bad. I personally don’t care if old people die since the existing old people refuse to pass better healthcare.

Like Kirk said; let them die. They don’t want to care about themselves, neither do I.

Physics doesn’t care about any of us. Only we do. If we want better healthcare do the political work to make so we can put agency into better healthcare and less agency into Wall Street’s war against line go down we’ve been waging for generations.

Treating?

We're great at that.

Curing?

Horrible.

Which is a real problem seeing as how people want to spend as much money as possible for diminishing returns on lifespan.

Medically speaking, "Geographic atrophy" is very poorly named. It is not descriptive at all.

Its good to know the same forces making software terrible are at work in the pharma business

The non-communicable chronic diseases are what my parents new, when they were still alive.

Recently I had to get my late father's paperwork in order and this meant going through lots of medical stuff. There was also paperwork regarding my mum, it was IPF that got her.

I also had to take a sack full of pills down to the chemist to get disposed of. This is in the UK where we have the NHS. The NHS would prefer to have people in good health whereas I suspect that the private healthcare system of the USA prefers to have people in bad health and medically dependent. It is just a different business model.

What surprised me about the NHS paperwork was how much of it was focused on lifestyle choices, so that means living a physically active life and eating certain foods.

My dad did the doctor visits and the pills but he did not do the lifestyle recommendations. He would behave like a tired toddler if you put fruit and vegetables on his plate. He was also heavily car dependent, as if any other mode of transport was not 'manly' enough for him. We had concerns for other road users with his driving but we could not get him to take the train, never mind walk as far as the nearest shop, five minutes away.

Alcohol was another cause for concern. Although never drunk, he would drink every day. He would have it with his greasy food, thinking he was eating like a king.

I know diet and nutrition is controversial, however, the NHS were wanting him to eat five portions of fruit and vegetables a day, and there were forms so that he could fill in how many grains, nuts, seeds, potatoes, vegetables and pieces of fruit he was eating. He wasn't eating any of those things, he was on the saturated fats, which invariably come from animal products. There were no checkboxes on the form for meat, cheese or processed foods, which is no surprise since there is no fibre in any of this stuff. There aren't any antioxidants either.

The NHS prefers lifestyle interventions rather than pills. This varies by doctor, but, this is the general idea.

Age related diseases are not due to age, in this day and age. They are down to poor lifestyle choices, cancer and all. Forget genetics too, sure, some people win the lottery, and others lose the cancer lottery. But the more you know then the more you realise that no amount of pills, procedures and testing will spare anyone from blocked arteries due to saturated fats with side portions of bad cholesterol.

It is the same with alcohol. If we treated pensioners as if they were under age, to ban them from obtaining alcohol, then there would be a lot of miserable pensioners but they would be living a lot longer. Same with processed food and animal products, if we banned pensioners from such things then they would be miserable but live out to be a hundred years old.

Face to face with my dad's NHS paperwork made me realise that I knew what I was reading all along. For decades we have known what gives you the non-communicable chronic diseases. We have also known that it is fibre and phytonutrients from whole foods that enable your body to protect itself against things such as inflammation.

Looking for cures is grift. There is no cure or treatment for those that spend hours a day consuming toxins whilst they pretend they are living like a king just because they are eating heavily marketed animal products that are sold as 'good for protein'. With health and longevity, you can't have your cake full of transfats and eat it.

TLDR: very bad.